| 摘要: |
| 目的:探讨支气管肺炎(BP)患儿发生药物相关问题( DRPs) 的影响因素,并建立列线图模型,评价分级管理策略对BP
患儿的干预效果。方法:选取2023 年1 月至2024 年6 月我院接受药物治疗的216 例BP 患儿,按DRPs 发生情况分为DRPs 组
与无DRPs 组。建立BP 患儿发生DRPs 的列线图模型,并评估其预测效能。另选取2024 年7-12 月在我院接受药物治疗的BP
患儿92 例,根据列线图预测模型对BP 患儿药物治疗风险实施分级药物治疗管理(MTM),评价BP 患儿的肺功能、用药依从性
改善情况。结果:年龄、二手烟暴露、静脉滴注、联合用药≥3 种、用药依从性差、肥胖是BP 患儿发生DRPs 的影响因素( P<
0. 05)。BP 患儿发生DRPs 的列线图模型的ROC 曲线下面积为0. 825(95%CI 0. 748~0. 902);校准曲线的预测值与实际值拟合
度较好;决策曲线显示,阈值概率为9%~74%时,该列线图模型具有正向净获益。与对照组相比,干预组BP 患儿的肺功能第1
秒用力呼气容积(FEV1) / 用力肺活量(FVC)值和用药依从性评分均提高(P<0. 05)。结论:本研究围绕BP 患儿MTM,构建列
线图预测模型,其校准度、区分度及临床适用性都表现良好,能够精准识别BP 患儿的用药安全风险。 |
| 关键词: 列线图 支气管肺炎 药物治疗管理模式 患儿 药物相关问题 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2026.07.003 |
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| 基金项目:2022 年度出生人口健康教育部重点实验室联合安徽省妇幼保健协会开放课题,编号AHFY202204。 |
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| Risk Prediction of Medication Issues for Children with Bronchopneumonia Based on Nomogram Model andConstruction and Evaluation of Medication Therapy Management Model with Graded Medication TherapyManagement |
| Yang Huan, Liu Xue, Du Min, Wang Yang, Wang Xuemei |
| ((Ma’anshan Maternal and Child Health Care Hospital, Anhui Ma’anshan 243000, China)) |
| Abstract: |
| Objective: To investigate the influencing factors of drug-related problems (DRPs) in children with bronchopneumonia
(BP), establish a nomogram model, and evaluate the intervention effects of graded medication therapy management (MTM) strategy on
children with BP. Methods: From Jan. 2023 to Jun. 2024, totally 216 children with BP received drug therapy in our hospital were
selected to be divided into the DRPs group and non-DRPs group based on the occurrence of DRPs. A nomogram model for predicting
DRPs in children with BP was constructed, and its predictive performance was evaluated. Another 92 children with BP who received
drug therapy in our hospital from Jul. to Dec. 2024 were extracted. Based on the risk predicted by the nomogram model, the graded
MTM intervention was implemented. Improvements in lung function and medication compliance were evaluated. Results: Age, exposure
to passive smoking, intravenous infusion, drug combination ⩾3 kinds, poor medication compliance, and obesity were risk factors for
DRPs in children with BP (P<0. 05). The ROC area under the curve of nomogram model for predicting DRPs was 0. 825 (95% CI
0. 748 to 0. 902). The calibration curve demonstrated good agreement between the predicted and actual values. Decision curve analysis
indicated that when the threshold probability ranged from 9% to 74%, the nomogram provided a good net benefit. Compared with the
control group, both the forced expiratory volume in one second/ forced vital capacity (FEV1/ FVC) ratio and medication compliance
scores were significantly higher in the intervention group of children with BP (P<0. 05). Conclusion: This study develops a nomogram
prediction model based on MTM for children with BP. The model demonstrates good calibration, discrimination, and clinical
applicability, enabling accurate identification of medication safety risks in children with BP. |
| Key words: nomogram bronchopneumonia medication therapy management model children drug-related problems |
